The majority of people living with hepatitis C have not yet sought the direct acting antivirals that could cure them, Hepatitis Australia is warning.

A year after their listing on the PBS, an estimated 17 % of people with the infection have accessed DAAs – the breakthrough therapy credited with a 90% cure rate and the potential to eliminate HCV in Australia.

Hepatitis Australia CEO Helen Tyrell said the early wave of motivated and engaged people who sought treatment exceeded all expectations.

“But there has been a sharp decline since and the real challenge is now reaching the remaining 200,000 Australians living with hepatitis C,” she  told the limbic.

This includes a proportion of people who remain undiagnosed.

The Kirby Institute estimates over 230,000 people have chronic hepatitis C in Australia.

Some 38,470 accessed DAA treatment in the 12 months to March 2017, the first year in which the medications were PBS listed.

“People who were motivated, engaged and knew about the medicines are in the liver clinics and have now all been treated,” Ms Tyrell said.

Now it is necessary to reach those who have not – diverse cohorts scattered across Australia which include people who are undiagnosed, people who are diagnosed but don’t know about DAAs, and people who are diagnosed but “not thinking about hepatitis C”.

“We need to find these people,” she said, adding that GPs will play a crucial role in the outreach.

Last year, 62% of patients taking DAAs were prescribed by specialists, compared to 19% by GPs.

Kirby Institute Professor John Dore, an infectious diseases expert at St Vincent’s hospital in Sydney, said the rise in GPs and other non-specialist clinicians prescribing these treatments will help reach into diverse populations.

“Broader access is vital if we are to sustain these impressive treatment figures and eliminate hepatitis C in Australia by 2026.”

Specialists can assist GPs with this process by educating them about how to use the treatments, and smoothing the consultation process in which GPs require specialists to review their treatment plan before they can prescribe DAAs, Ms Tyrell said.

“We need that consultation process to happen quickly.

“People who have steeled themselves up to go see a GP want to get the treatment quickly. If all these processes take too long sometimes people will retreat again.”

Meanwhile, the first pan-genotypic antiviral sofosbuvir (Epclusa) will be PBS listed from August 1.

The new therapy is more than 90 per cent effective in achieving a cure within 12 weeks, regardless of hepatitis C genotype, according to Hepatitis Australia.